Document 0242
 DOCN  M9590242
 TI    Undiagnosed pulmonary infiltrates in HIV patients--what is the role of
       open lung biopsy?
 DT    9509
 AU    Marshall C; Street A; Royal Melbourne Hospital, Parkville.
 SO    Annu Conf Australas Soc HIV Med. 1994 Nov 3-6;6:282 (unnumbered poster).
       Unique Identifier : AIDSLINE ASHM6/95291857
 AB    OBJECTIVE: To describe an HIV positive patient with an unexplained
       pulmonary infiltrate who underwent an open lung biopsy and to review the
       role of open lung biopsy in HIV patients. METHODS: We provide a case
       description, a review of patients at The Royal Melbourne and Fairfield
       Hospitals who have undergone open lung biopsy and a review of the
       literature on this subject. CASE REPORT: The patient was a 29 year old
       HIV positive man with a past history of cutaneous Kaposi's sarcoma and a
       CD4 count of 0. He presented with worsening shortness of breath and
       bilateral pulmonary infiltrates following an episode of proven
       Pneumocystis carinii pneumonia. Induced sputum and bronchoscopy were
       negative. An open lung biopsy was performed and a diagnosis of pulmonary
       Kaposi's sarcoma was made histologically. The patient died a week after
       the procedure. REVIEW OF OTHER CASES: Five other patients have had an
       open lung biopsy performed amongst a total of almost 900 AIDS patients
       treated at The Royal Melbourne and Fairfield Hospitals. All patients had
       late stage HIV infection. New diagnoses were made in a majority of
       patients, but were usually not treatable and postoperative survival was
       short. The literature on open lung biopsy in HIV patients will also be
       reviewed. CONCLUSION: Open lung biopsy is rarely performed in HIV
       patients. Useful information can be obtained by excluding infections
       such as PCP and tuberculosis (thereby avoiding unnecessary therapy),
       while the patient and family can be made aware of the diagnosis and its
       prognosis. In general however, open lung biopsy rarely reveals a
       treatable diagnosis and has a very limited role in the evaluation of
       undiagnosed pulmonary infiltrates in HIV patients.
 DE    Adult  AIDS-Related Opportunistic Infections/*PATHOLOGY  Biopsy  Case
       Report  Diagnosis, Differential  Human  HIV Seropositivity/*PATHOLOGY
       Lung/PATHOLOGY  Lung Neoplasms/PATHOLOGY/*SECONDARY  Male  Sarcoma,
       Kaposi's/PATHOLOGY/*SECONDARY  Skin Neoplasms/*PATHOLOGY  MEETING
       ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).